Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec;31(2):259-266.
doi: 10.1007/s40199-023-00481-z. Epub 2023 Oct 17.

Utilization patterns of cardiovascular medications in patients with diabetes mellitus; a retrospective cross-sectional study, 2013-17

Affiliations

Utilization patterns of cardiovascular medications in patients with diabetes mellitus; a retrospective cross-sectional study, 2013-17

Negin Hatami et al. Daru. 2023 Dec.

Abstract

Background: Diabetes Mellitus (DM) is a prominent health care issue worldwide. One of the most prevalent comorbidities of DM is cardiovascular disease (CVD). The objective of this study was to assess the utilization patterns of cardiovascular medications in patients with DM in Iran from 2013 to 2017.

Methods: This retrospective cross-sectional study was undertaken using prescription claims data from 2013 to 2017 in Iran. Epidemiological data elements used in this study were obtained from the Global Burden of Disease (GBD) 2019 study. In addition, data on total medication sales were obtained from the national regulatory authority database. The data on medication utilization were analyzed according to the Anatomical Therapeutic Chemical Classification (ATC) /Defined Daily Doses (DDD) international system.

Results: Based on the findings, Acetylsalicylic acid was the mainstay of treatment with a utilization rate of 191.7 DDD/ patient/ year in 2017, followed by Atorvastatin with 170.0 and Losartan with 115.1. Although there was an increasing trend in the utilization rate of the medications, the rate of Atenolol and Enalapril was constantly declining during the 2013-17 period. On the other hand, Valsartan and Metoprolol were attracting attention. Almost all medication utilization rates increased from the 30-39 age group up to the 80 + age group. Females had a higher utilization rate in each age group during the whole study period.

Conclusion: The present study reflects that medication utilization patterns were rational, according to the standard treatment guidelines. Utilization patterns of medications that are recommended for both prevention and treatment of CVD in diabetes were observed to be the highest. Implementation of further policies is needed to minimize cardiovascular complications of diabetes.

Keywords: Cardiovascular Disease; Defined daily dose; Diabetes Mellitus; Medication utilization patterns.

PubMed Disclaimer

Conflict of interest statement

The authors have no competing interests to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
The rates of CVD medications utilization per known case of DM by gender in Iran during 2013-17. Medications with multiple dosage forms are adjusted based on DDD. Rates less than 0.1 were excluded
Fig. 2
Fig. 2
The rates of CVD medications utilization per known case of DM by Age (20–60) in Iran during 2013-17. Medications with multiple dosage forms are adjusted based on DDD. Rates less than 0.1 were excluded
Fig. 3
Fig. 3
The rates of CVD medications utilization per known case of DM by Age (60+) in Iran during 2013-17. Medications with multiple dosage forms are adjusted based on DDD. Rates less than 0.1 were excluded

References

    1. International Diabetes Federation . IDF Diabetes Atlas. 10. Brussels, Belgium: International Diabetes Federation; 2021. - PubMed
    1. Azadnajafabad S, Ahmadi N, Rezaei N, Rashidi M-M, Saeedi Moghaddam S, Mohammadi E, et al. Evaluation of the diabetes care cascade and compliance with WHO global coverage targets in Iran based on STEPS survey 2021. Sci Rep. 2023;13(1):13528. doi: 10.1038/s41598-023-39433-7. - DOI - PMC - PubMed
    1. Acs A, Ludwig C, Bereza BG, Einarson TR, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: A global systematic review. Value Health. 2017;20(9):A475. doi: 10.1016/j.jval.2017.08.435. - DOI
    1. Low Wang CC, Hess CN, Hiatt WR, Goldfine AB. Clinical update: cardiovascular disease in diabetes mellitus: atherosclerotic cardiovascular disease and heart failure in type 2 diabetes Mellitus - mechanisms, management, and clinical considerations. Circulation. 2016;133(24):2459–2502. doi: 10.1161/CIRCULATIONAHA.116.022194. - DOI - PMC - PubMed
    1. Newman JD, Schwartzbard AZ, Weintraub HS, Goldberg IJ, Berger JS. Primary Prevention of cardiovascular disease in diabetes mellitus. J Am Coll Cardiol. 2017;70(7):883–893. doi: 10.1016/j.jacc.2017.07.001. - DOI - PMC - PubMed